662LOT NO.
•t+ "t.xAF. d.: NO. STREET
APPLICATION, FOR GAS ,PERMIT
CITYt�OF CUPERTINO
^ I JUL 241959 U1
Date J U I 2-2-1959 195_
a
J.
CITY OF CUPERTINO
Permit No. 6
:-Fee $
Application is hereby made to the City of Cupertino for a permit to. install gas pipes
and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
and/or appliances in accordance with the provisions of the Plumbing Code:'of-the, City
of Cupertino, and all other laws applicable thereto. s
Use of Premises
Owner
By— —REA---- - - -- - Ld
II%4i% $evensc�rec Renta Clare, CaRI,
Phone
Address,
Address
Approved
PL,m.L" 1NSpECToR
Type of Appliance Units Fees
Remarks (Check J) -
NewI ReplaceI Relocate
Gas' Ranges I
a Heaters • .�
.I
I
Gas Plates
Circulating Heaters I• ' ` .Irk
Blower Furnaces <' y;
�s Fir rBoilers
Warm Ing Ovens i
rN
Per'Colitors
Griddles I II
,jSteam Tables
7. I I
': Gravity Furnaces
Suspended Unit
Floor Furnace
II
''Miscellaneous
I NAME TYPE) I
I
I I
II I I
%J V I I
II I I
pp lance Fees a /. C
Inspected and Approved/df..../F':...!
.. ! .........................
DATE [/ INSPECTOR
HOUSE'GAS PIPING,;.
Number of Outlets I ' Size'.;oflMain
Gas Piping Fees
_1
PP ..._L..
Tested and Approved ..... -..........................................
pj DATE INSPECTOR
0
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